Katie Kosko

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Two years of pitavastatin use can help lower noncalcified plaque volume and inflammatory biomarkers in people living with HIV who are at risk of cardiovascular disease (CVD) compared with placebo, according to a recent substudy of the REPRIEVE clinical trial.
The substudy, <a href="https://jamanetwork.com/journals/jamacardiology/article-abstract/2815081">published</a> in JAMA Cardiology, evaluated 611 people with HIV who had low to moderate risk of CVD. “CVD is increased in people with HIV and is characterized by premature noncalcified coronary plaque,” the researchers said.
Therefore, they investigated whether 24 months of pitavastatin 4 mg orally a day could reduce noncalcified coronary plaque measured by computed tomography angiography (CTA) and inflammatory biomarkers.
People were enrolled between April 2015 and February 2018 at 31 sites across the United States and were randomly selected to either the pitavastatin arm (n=302) or the placebo arm (n=309). The trial was primarily made up of men (84%) who were a mean age of 51 years. The median 10-year CVD risk was 4.5%. The median low-density lipoprotein (LDL) cholesterol level was 108 mg/dL. CTA was done at baseline and 24 months.
The researchers determined that the pitavastatin arm had a significant 7% relative reduction in noncalcified plaque compared with the placebo arm. Moreover, pitavastatin reduced progression of noncalcified plaque by 33% versus placebo. The pitavastatin arm also had a reduction in LDL cholesterol (mean change: pitavastatin, −28.5 mg/dL; 95% CI, −31.9 to −25.1; placebo, −0.8; 95% CI, −3.8 to 2.2) and biomarkers of lipid oxidation and arterial inflammation.
“These findings provide insight into how pitavastatin may prevent [major adverse cardiovascular events (MACE)],” the researchers said.
The findings of this double-blind, placebo-controlled, randomized clinical trial may also contribute to the REPRIEVE study, which showed that pitavastatin reduced MACE by 35% over a median of 5.1 years.

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Noncalcified Plaque Volume in People With HIV at Risk of CVD Reduced by Pitavastatin

Two years of pitavastatin use can help lower noncalcified plaque volume and inflammatory biomarkers in people living with HIV

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